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97 Seconds
97 Seconds is a 4th season episode of House which first aired on October 9, 2007. A wheelchair bound man is admitted after he passes out in his wheelchair. House decides to make a game of it and pits the female applicants against the male applicants with the losing team being eliminated. The manipulative “Cutthroat Bitch” decides to play both sides to increase her chances. However, after one of the applicants prescribes what seems to be the right treatment, the patient doesn’t improve and House has to work harder than ever to save him. Meanwhile, House becomes intrigued with a man who has suffered a near-death episode. Although the episode's primary diagnosis focuses on a medical mistake, the real theme of the episode is life after death. This philosophical issue is brought to us by a young man who deliberately induces cardiac arrest to re-live a near death experience which he describes as the most intense thing he has ever done. As House is convinced that the euphoria is not the afterlife but the brain desperately trying to make itself feel better, he's also confronted with a crisis of his own making when his seemingly simple diagnostic case takes a turn for the worse and the patient turns to death as a solace for the limited life he lives due to his disability. House's dismissive attitude and Wilson's supportive one clash as House becomes convinced he has to settle the matter in his own mind once and for all. In the meantime, Foreman is involved in his own life or death struggle as he becomes convinced that he must act against protocol in order to treat his first real case. Like House, we known Foreman is an atheist and is most likely driven by his own belief that nothing exists for his own patient apart from the life she's tenuously clinging to. See The Applicants for more information about the cast of this episode. Recap A wheelchair-bound man is out with his companion dog when he suddenly lapses into unconsciousness in the middle of the street. His dog manages to avert disaster by warning an oncoming driver and gets the attention of passers-by to help. Meanwhile, the remaining applicants are impatiently hanging out in the lecture hall waiting for House. As the manipulative applicant starts to leave, House finally arrives with a case. He wants to split them into competing teams, and finally decides to go by sex. However, Amber wants to join the men. House hesitates to allow this and finally decides to leave it up to the men. The men refuse to let her join. The teams split up and discuss strategies. Thirteen suspects House already knows the answer. The men’s team decides to run as many tests as they can. Meanwhile, Cameron is busy in the emergency room. Amber tells her House has turned patient care into a game, and plays on Cameron's empathy to enlist her help. Thirteen thinks the patient has encountered a parasite (strongyloides during his trip to Thailand) and gives the patient treatment—two tablets of ivermectin. Kutner comes in to do tests and has Brennan carry the patient to the bathroom to take a stool sample. House drops in on Cuddy while his teams use his office. She tells him he can't make a competition out of patient care. Cuddy thinks House already knows what is wrong. He instead wants to talk about the clinic patient, but Cuddy remains focused on the competition. House threatens to fire all the applicants if Cuddy stops him, and then to re-start the process with new applicants. Meanwhile, Foreman is leading his own team at New York Mercy Hospital, doing a differential in a manner very similar to House. After realizing their patient might be having vison problems due to the fact she's given up crossword puzzles, he thinks it is aspergillis and orders treatment. Amber offers the men help so House will have to pick her as the only remaining woman. She says she has a diagnostic strategy directly from one of House's former fellows. The plan is to have bugs bite the patient and then test the bugs' excrement for parasites—xenodiagnosis. As they begin the test the patient goes into respiratory distress. The patient improves when put on oxygen. His problem is that the air is going into his stomach instead of his lungs. Thirteen thinks it's related to the condition that makes him wheelchair-bound. One of the Twins suggests putting him on a tilt table to stress him. House punishes the male team for doing too many tests by making them sit out, and tells them one of them isn't a real doctor. Meanwhile, Foreman is having problems diagnosing his patient when the first diagnosis turns out to be wrong. He starts concentrating on why the patient’s liver just failed. The male team is sequestered in House's office with instructions not to talk. They break the rule and start interrogating each other to learn who is not a doctor, then start discussing the case instead. They think it might be a tumor, and wonder how to get away to test the patient. Amber sneaks out of the room when they realize they are being monitored from House's computer. The other team is testing the patient on the tilt table, but the patient enjoys it and shows no ill effects. House holds a "tribal council" in the lecture hall. He fires the men for failing the test. Amber arrives with a CT Scan, offering a diagnosis of scleraderma, but House tells her she has the wrong diagnosis and that strongyloides was the right diagnosis. House tells the female applicants to put the patient on a feeding tube. Amber asks Chase to do the blood test she is not allowed to do, to prove she was right. He refuses because he knows she was fired, so she appeals to his desire to irritate House. He knows he's being manipulated and thinks she's wrong, but agrees anyway. She draws blood for the lab tests, and discovers the patient's blood is green. The teams discuss why the patient's blood is green. House admits that he was wrong about the strongyloides diagnosis and allows the men to return. The plastic surgeon thinks it is because the patient couldn't process the CT's contrast dye through his kidneys. They discuss why the patient's kidneys might be failing. House confronts Chase about helping Amber who was officially fired. Chase stands up to him. Cameron tells House how much she likes Chase like this. The patient develops pneumonia and all the tests come back negative. House deduces it must be cancer. Foreman finally determines the correct diagnosis for his own patient—a fast acting form of lymphoma. He suggests radiation therapy to his superior. She notes that he hasn't ruled out infection, which would be easier and safer to treat; Foreman argues that there's no time for a textbook approach, but she counters that radiation therapy is too dangerous because if he's wrong the patient will die even more quickly. She thinks he is still worried about the patient he lost with a wrong diagnosis, tells him not to make the same mistake twice, and orders antibiotics. She tells him to confirm the cancer but he points out that if it is cancer, it will be too late to treat her once it's confirmed. Meanwhile, House is planning on removing the patient's eye to see if it has melanoma. Cuddy wants him to do a biopsy, but the patient will be dead before they can get the results. If the patient does have melanoma he will only have months to live, because it's too late to successfully treat it. The patient is resigned to dying rather than spending the rest of his life in bed trapped in a useless body, and says he wants to know what exists after death. When House tells him the afterlife is bogus, Wilson throws him out of the room. Wilson then angrily confronts him about not letting the patient have a little comfort in his beliefs. When House says that it's all a lie and that "misery is better than nothing," Wilson tells him that he doesn't know any better than anyone whether there is an afterlife. Foreman stares at his whiteboard and decides to take his patient for radiation therapy. The team start palliative care on the patient. They discover that the patient isn't bleeding internally, which he should be doing if he has cancer. Amber gets a page from House, and as she approaches his office, finds he has electrocuted himself the same way his clinic patient did. She starts CPR. The team discuss what happened to House. Wilson arrives and tells them he is alive but unconscious. They start talking about the case again. Brennan suggests eosinophilic pneumonia. House wakes up to find Wilson calling him an idiot. Wilson fills him in on the patient and tells him the clinic patient is dead. House said he shocked himself because Wilson challenged him to see the afterlife for himself. Wilson reminds him that he has already had two other near-death experiences. Wilson asks House what he saw but House doesn't respond. Wilson says, "Just looking at you hurts. I'm gonna order up some more pain meds." House responds in an unexpectedly heartfelt tone, "I love you." The applicants give the patient steroids for his pneumonia, but he doesn't get better. He asks for his companion dog to be placed on the bed with him. He soon goes into cardiac arrest and dies. Amber tells House the patient is dead. House says death is not a diagnosis, and gets out of bed to see the patient. She wants to know why he paged her, but he's evasive, claiming he knew she wouldn't let him die because she wouldn't get the job if he were gone. House is discussing the patient with the applicants when they realize the dog is dead too. The veterinarian mentions that companion animals often live beyond their normal lifespans to stay with their masters, dying soon after the human has passed. House asks Thirteen if she saw the patient swallow the ivermectin, but she's not sure. House finds the empty pill cup on the floor, with dog bites in the plastic. The dog, an English Sheepdog, has died because of an adverse reaction to the medicine due to a defect in its MDR1 gene. House angrily tells Thirteen that the answer to the question was "No, I didn't see him swallow the pills." Cuddy tells House he screwed up and is responsible for the mistake his applicant made. Meanwhile, Foreman’s patient quickly improves, confirming his diagnosis. However his superior fires him for acting on a hunch and disobeying her orders instead of following protocol. Strongyloides is what killed House's patient, because he didn't take the pills. Because he believed the patient had taken the ivermectin, House ruled it out, even though it was one of his initial theories. House finds Thirteen in the morgue with the dead patient. Thirteen tells him that as soon as they cut into his lungs they saw the parasitic threadworms. House doesn't fire Thirteen, but does give her a lecture, telling her that because she screwed up this time, she would never make the same mistake again. He says he fired the rest of her team even though their diagnosis was correct. Thirteen leaves and House says to the patient's body, "I'm sorry to say, I told you so." Eliminations Twins and Jodi are fired by Cuddy and House for killing the patient. Thirteen redeemed herself when she found the worms inside of the patient and the dog but only postmortem and was spared. Applicants Remaining: 7 Clinic Patient House greets a patient, who pulls a knife, but instead of attacking House, sticks it in an electrical outlet to electrocute himself. House calls in a crash cart, but wonders why the patient would do this. He can't get Cuddy or Wilson interested in the problem. House visits the patient in intensive care. He tells House that he was in a head-on collision and was clinically dead for 97 seconds. He describes the experience as the best of his life. When House tries to give him a medical explanation of "a flood of endorphins and serotonin" in the brain, the patient rejects it, stating that he's done every hallucinogenic drug there is, and those experiences were nothing compared to what he experienced while dead. The patient believes there is "something out there" after death. Despite not believing in the afterlife, House is surprised and intrigued. As his other patient has the same belief in the afterlife, House derides his philosophical beliefs saying the afterlife is bogus. After arguing with Wilson, House returns to the clinic patient, but when the clinic patient looks at him, he leaves. After House electrocutes himself in an 'experiment' to find out if there is an afterlife, House says to Wilson that he needs to talk to the clinic patient. Wilson tells him the patient died an hour ago, and asks why House wants to see him. House doesn't respond. Title The title is drawn from the length of time that the clinic patient was told he was clinically dead. Goofs * It's unlikely that, in normal circumstances, the clinic patient could have electrocuted himself by sticking a sharp object in one hole of a two hole outlet. Electricity only flows through a complete circuit, so the clinic patient would have to be grounded. People who electrocute themselves are generally also touching a screw on the plate (which is grounded), or are standing on metal or in water (which provides a ground). A person in normal shoes standing on a dry floor with concrete underneath doesn't provide a path for the electricity, at least not at 120 volts of typical current. In addition, in order to induce cardiac arrest, the voltage would have to follow a path that took it through the heart. Assuming the charge would have passed through him, it would have passed down his arm, down his right side, and down his leg. He would probably have a very nasty burn, but not a cardiac arrest. In addition, house current, even if it does pass through the heart, may cause an arrhythmia, but not cardiac arrest. By contrast, a defibrillator can hand out a shock of up to 1,700 volts with a minimum of 200. * When the bottle being used to drain Stark's lungs fills up, Dr. Desai is clearly seen changing it for an empty one. However, in the next shot, the bottle is full again. * Polite Dissent noted that he couldn't explain how the final diagnosis caused fainting. Only disseminated strongyloides (where the worms are just about everywhere) can lead to fainting. * No one tested for strongyloides. Although they had trouble getting a stool sample (and it doesn't show up in all samples - seven are recommended) there are reliable blood tests for it. * Using a tilt table to try to induce fainting to confirm strongyloides is also not a good idea. A tilt table can confirm a diagnosis of other conditions, such as orthostatic hypertension, that cause fainting. * House is not correct about how the lymphatic system works. Several parts of the body apart from the eye drain into the same lymph node. * House took an absence of near-death experience, when he electrocuted himself, as a proof that he is right about there being no afterlife. However, NDEs only manifests in roughly 10-20% of cardiac arrest cases (the alternative being that only 10-20% of people remember them). Zebra Factor 2/10 Strongyloides isn’t endemic to New Jersey, but it is common in people who travel abroad. Major Events *It is shown that there are now ten fellowship applicants left in the game. *House pegs the applicant who will be revealed to be Lawrence Kutner as a former foster child. *House splits them in two teams, men vs women. Amber Volakis (the manipulative applicant) leaves her group and joins the men's team instead, so as to be the only woman standing if the other women fail. *Due to her manipulative personality, the applicant is dubbed Cutthroat Bitch by both House and Kutner, which soon becomes her official nickname. *House meets a patient in the clinic who immediately electrocutes himself. *Now that he has become Head of Diagnostics at Mercy, Foreman is shown to be working with his own team. *Travis Brennan, Number 37, reveals that he worked with Doctors Without Borders for eight years. House figures out he's also engaged and only wants the job because the fiancé lives locally. *House drops hints about one of the men not being a real doctor. *House confronts the patient who purposely electrocuted himself in the clinic. The patient reveals that he was in an car accident and actually died at the scene. He described being technically dead as the best 97 seconds of his life but when he asks for his knife back, House refuses to give it to him. *Wilson and Amber meet for the first time, although it's very brief. *House holds a Tribal Council in the hall and fires all the men. *In an attempt to stay in the game, the manipulative applicant asks Chase and Cameron to help her out, even though she was technically fired as part of the men's team. *House confronts Chase over aiding the manipulative applicant. *With the possibility of their respective patients having cancer, House calls Wilson in for a consult. *House and Wilson have an argument over the patient's beliefs about the afterlife. *At Mercy, Foreman goes against protocol to save a patient. *The clinic patient dies an hour before House regains consciousness after House electrocutes himself to see if there is an afterlife. House never gets to talk to him about the afterlife. The clinic patient died because he had internal injuries when he electrocuted himself. *Stark, the main patient, dies because he did not take the pills that would have helped him. *The manipulative applicant confronts House over him paging her. *House learns that the patient's dog has also passed away. They discover that the dog ate the pills intended for its owner. *Foreman is fired from Mercy for disobeying his supervisor. *House fires Jodi Desai and the twins but spares Thirteen as he is confident she won't screw up again. *House says to the patient's body, "I'm sorry to say, I told you so", implying he didn't see an afterlife. *House is able to easily read the applicants, except for Thirteen whose life history evades him. Trivia & Cultural References *Stark's dog was an English Shepherd. About 15% of the breed has the MDR1 gene mutation that leads to adverse reactions to many canine medications, including Ivermectin. Veterinarians can check individual animals by doing a cheek swab and doing genetic testing. *A "Pied-Piper" is a reference to the folk tale of the Pied Piper of Hamelin. "Pied" is a term for someone dressed in multi-colored clothing. In the legend, the Piper used his music to lure all the rats out of the town and into a nearby river where all but one drowned. However, when he was denied his fee, he used his music to lure all but three of the children out of the town and into a cave where they were never seen again. *David Blaine is an American magician, known for his unique approach of focusing on audience reactions to his tricks during his televised broadcasts rather than the tricks themselves. *The reference to "Tribal Council" is from the reality television show Survivor *The Confederates and the Yanks (Yankees) were the opposing sides in the American Civil War. *Jeffrey Cole’s nickname “Big Love” is from the American drama series of the same name about a polygamous fundamentalist Mormon. *In the Star Trek canon, Vulcans have copper based blood and “bleed green“, unlike humans red blood color, which comes from the iron in hemoglobin. Leonard Nimoy played the Vulcan Spock. *Hail, locusts and smiting the firstborn are three of the Plagues of Egypt from the Book of Exodus. *The reference to “72 virgins” is from the Islamic concept of heaven. *Detroit is the largest city in Michigan, the largest border city in the United States, and the 23rd largest city in the United States. *A bit of irony: House is wrong about his patient having cancer and the patient dies, but House keeps his job regardless of his error. Foreman is right about his patient having cancer and saves the patient’s life, but gets fired. *House's line to Henry "I think I will miss you most of all, you ridiculously old fraud" paraphrases Dorothy's farewell to the Wizard of Oz in the 1939 movie version. *Wilson's line "The rain in Spain doesn't actually fall on the plain all that much" is from the musical My Fair Lady. Professor Higgins uses the words with they "ay" sound so that Eliza can practice not saying "oi".. *The episode features a character who would go on to play a minor recurring role in another FOX show, Bones; Brian Klugman (The main patient of the episode). Charlie Hoffheimer would go on to play Anne Dudek's husband on Grey's Anatomy *As the clean-up team comes in to care for the electrocuted clinic patient, House states, “I didn’t do it.” - a often-used quote from Bart Simpson. *Ann Dudek, who plays Amber Volakis, guest starred in Criminal Minds in 2012. Her character there is a hypochondriac who previously had a bout of scleroderma, a diagnosis Amber suggests in this episodehttps://criminalminds.fandom.com/wiki/Emma_Kerrigan. Reviews * Polite Dissent gave the medicine a "C", but was impressed by the final resolution because it was so unexpected. However, he thought the non-medical plot was excellent and gave it an "A". * TV.com users rated the episode an 8.8. Thanks to Chase's defiance of House, the voters chose Jesse Spencer as the Most Valuable Performer in the episode. * IMDB users rated the episode an 8.8, with 36.1% of users rating it a "10". It rated best with users aged 18-29 (9.1) and worst with males under 18 (7.3) Medical Ethics Using patients for teaching purposes Patients at a teaching hospital like PPTH will expect to deal with physicians in training, whether they be interns, residents of even fellows. Depending on their stage of development, a physician in training will most likely take a lot longer to reach a diagnosis or perform a procedure than a board certified specialist. However, withholding information from physicians in training is a standard training procedure. For example, during grand rounds, the physician in charge will often ask a student for a diagnosis based on the known symptoms being exhibited by the patient. In almost every case, the physician knows the diagnosis and wants to see if the student can reach the same conclusion, particularly if the condition is a common one. Students are encouraged to ask questions which the physician answers honestly. However, a student who misses is not treated as a "failure", but as a learning experience for the entire class not to overlook key symptoms in making a diagnosis. House typically pushes his fellows to extremes during a differential, and pits them against each other to point out the flaws. The "winner" is the person who can get a diagnosis that fits and that neither House nor his fellows can disqualify for any reason. An "out of bounds" argument by a fellow is when they object to a diagnosis because treating it would be dangerous. However, House is training a team that has to look past the commonplace and to "undo" their training in their given field so they don't jump to conclusions. As such, turning this into a "game", particularly where the patient is in on it, isn't completely unethical. At worst, House probably didn't supervise his team very well. Thirteen's mistake is, ethically speaking, House's mistake. There is a lot House could have done to prevent this. Strongyloides is easy to confirm, even if you don't have a stool sample. When Stark didn't respond to treatment, a medication error probably would have jumped to the top of the list. Going against procedure Foreman does what House has probably done a dozen times himself - he gave his patient a dangerous treatment without confirming a diagnosis. Moreover, the writers and producers raised the stakes - they give the patient the exact same symptoms as the patient who convinced Foreman he had to quit in House Training and gives him the same dilemma, essentially daring him to make the same mistake again. He treats his patient identically to how he treated Lupe - radiation therapy. In House Training, Foreman is chastened by his own mistake. You can see his confidence and bravado drain before your eyes as House figures out that not only was Foreman's diagnosis wrong, the treatment has doomed the patient. However, in essentially what is his first day at his new job, his own insecurities find a new strength and, far from teaching Foreman not to repeat his mistake, allow him to press forward knowing that he could be making a mistake. But Dr. Schaffer is right - Foreman was proceeding on a guess. It's a guess that turned out to be right but, if the patient was suffering from an infection, the radiation would have been as fatal to this patient as it was to Lupe. She was well within her rights to fire him and to hope he would learn another valuable lesson - that the hope of saving a patient doesn't override keeping the patient's best interests in mind at all times. The more dangerous the treatment, the more certain the physician has to be about the diagnosis. One of the criticisms of medical care in the modern world is, given the ability of modern medicine to extend some sort of life functions indefinitely, just how much effort should be used on each individual patient. Despite the talk of "death panels", having clear protocols for patients in the last stages of life is still not a standard procedure, which, at least in the United States, often means that people consume as much medical care in their last week of life than they do in the rest of their life combined. We must also remember the lessons of the past when people were essentially treated as guinea pigs to test out questionable medical theories. This has led to the modern requirement of informed consent for experimentation. All too often, people with terminal medical conditions will grasp at straws, including alternative medicine, when there are treatments that may not cure the condition, but may still allow a better quality of life. Conversely, there are medical treatments that may extend life, but only at the expense of quality of life - chemotherapy in particular is a delicate balancing act. Providing medication Pharmacotherapy, or the use of pharmaceuticals to treat chronic conditions, is now one of the most common treatments used by physicians. However, in hundreds if not thousands of cases each year, a patient's failure to consistently take their medication often results in premature death from the very condition they are being treated for. In some cases, particularly in the United States, the cost of medication can be prohibitive. However, in other cases, the patient may not appreciate the side effects, or in others the patient is unwilling or unable to take their medication at the recommended time in the recommended dose. Several conditions, such as diabetes mellitus and tuberculosis, require a strict adherence to the drug regimen. It is also an issue with many people suffering from mental illness - Alvie in Broken is a perfect example. As such, many physicians are of the opinion that it is the responsibility of the physician to ensure that a patient is properly following their pharmaceutical regime. In a case such as the one in this episode, it is up to one of the medical professionals to ensure that Stark took his pills. The fact that the dose was interrupted in the middle is no excuse - House is right that Thirteen should have known whether or not Stark actually took the Ivermectin, and she should have realized earlier that if the answer to that is "I don't know", then she should have at least asked the patient. Patients forget to take their medication for all sorts of reasons. Interruption of their normal routine is a common example. In Broken, the doctors in Ward 6 clearly understand their responsibility to make sure a patient is taking their pills, and they do so even though they realize that patients will often go out of their way to avoid doing so. When the doctors in that episode noted something seemed to be going wrong, it was easy enough to switch out the pills for placebos to test their hypothesis. When one watches the scene in retrospect, while Thirteen is giving the pills, the men's team comes along to take him to the washroom for a stool sample. Thirteen could have, and should have, insisted on interrupting the men to ensure that the patient was given his dose. It is likely that in the attempt to move Stark, the men's clumsiness resulted in the pills being knocked off the table onto the floor. Running tests House is right that the men were wasting their time by running every test they could think of. A similar approach was tried in Occam's Razor, where Foreman is sure it is a viral infection and keeps running tests hoping to find the right one. Foreman turned out to be entirely wrong, but at the time he believed the approach was sound. But House was right, running tests is pointless unless you have anticipated what the results might be. In addition to the fact there are thousands of possible tests to run, some of which can be invasive (even a blood draw is invasive and, in Maternity, you are reminded that humans don't have an unlimited supply to test), all these tests cost money. Particularly in the United States, over-testing, particularly with techniques that are dangerous and can cause disease (such as the radiation in a CT Scan, or the contrast agent in an MRI) is a serious problem that drives up medical costs across the board. In addition, every time you do a test, there's a chance you will either get the wrong result (a false positive - see Role Model for a good example) or you will find something that "demands" further investigation that turns out to be meaningless. In oncology, the need for "early detection" has created a culture where false positives are common and lead to invasive, dangerous or expensive treatments for conditions that either don't exist in the first place (such as a small benign tumor) or are unlikely to kill the patient (such as a slow growing malignant tumor the patient might outlive, particularly if they are already very old). For example, the increasingly aggressive treatments for prostate cancer often mean that a cancer that merely needs monitoring will instead lead to surgery that can lead to erectile dysfunction, incontinence or even complications leading to death. None of this has statistically led to longer lifespans as most people diagnosed with the condition are already in their sixties. Quotes Dr. Gregory House: I don't have to go to Detroit to know it smells.'' ''Dr. Wilson: Just looking at you hurts. I'm going to order up some extra pain medicine.'' ''Dr. Gregory House: I love you.'' ''Henry: It was the best two weeks of my life.'' ''Dr. Gregory House: I think I will miss you most of all, Ridiculously Old Fraud.'' ''Amber Volakis: Why did you page me?'' ''Dr. Gregory House: Because if I pooped myself in front of Wilson, I'd never hear the end of it.'' ''Thirteen: I know! Forget the lecture and fire me already!'' ''Dr. Gregory House: If I was going to fire you, I wouldn't be giving you the lecture. I know you're not going to let anything like this ever happen again. I'll see you tomorrow. leaves the room; House goes over to Stark's body And I'm sorry to say... I told you so.'' ''Dr. Gregory House: his cane to Amber Would you mind holding my metaphor for a second?'' ''Dr. Lawrence Kutner: Wait, how do you want us to split up?'' ''Dr. Gregory House: Good question, Overly Excited Former Foster Kid. There's ten of you. I was thinking six against six. No, wait...'' ''Dr. Wilson: Interestingly, the rain in Spain doesn't actually fall in the plain all that much.'' ''Amber Volakis: Dr. House? I'd like to be on the men's team.'' ''Dr. House: Do your sex organs dangle, Cutthroat Bitch?'' ''Amber Volakis: Not yet.'' ''Henry: We're not okay.'' ''Amber Volakis: I get it. You don't like me because maybe I'm a little bit... competitive.'' ''Dr. Chris Taub: Manipulative. Dr. Lawrence Kutner: '''Cutthroat Bitch is your official title. ''Amber: It's a game. You can either play for fun or play to win. If you want to win, you want cutthroat.'' ''Cole: No, thank you.'' ''Dr. Gregory House: Hey Wilson, I'm gonna cut some cripple's eye out! Wanna come watch?'' ''Dr. Wilson: Good times.'' ''Amber Volakis: Why do you guys keep a D-cell battery in a urine specimen cup?'' ''Dr. Allison Cameron: Because we pulled it from a patient's intestine.'' ''Amber Volakis: Why would somebody swallow a battery?'' ''Dr. Allison Cameron: Why do you assume it was swallowed?'' ''Dr. House: You like exotic. Why are you here?'' ''Dr. Travis Brennan: I want this job.'' ''Dr. House: Parents sick?'' ''Dr. Travis Brennan: No. I... I just...'' ''Dr. House: ...this is not the job you want. This is the job in the zip code you want. You engaged?'' ''Dr. Travis Brennan: Yes.'' ''Dr. House: Ta-da!'' ''Dr. Travis Brennan: Am I not allowed to grow up and change my priorities?'' ''Dr. House: You're allowed to. People usually don't.'' ''Dr. Eric Foreman: We were wrong and we're going to keep being wrong until we're right.'' ''Latino Fellow: Or until she dies.'' ''Dr. Eric Foreman: Yeah, that was very helpful. Need a team to tell me we're mortals.'' ''Dr. House: I check this box, and your next roommates are gonna be Jesus and Crazy McLoonyBin.'' ''Dr. House: Who are you, Thirteen?'' ''Thirteen: My name's in the file.'' ''Dr. House: The fact that you won't answer my questions tells me more about you than answers could.'' ''Thirteen: No, it doesn't. We turned the thing up to 95 degrees...'' ''Dr. Wilson: Do you think that non-answers tell me anything?'' ''Thirteen: Sure. Just not as much as actual answers. That's why they are called answers.'' ''Dr. House: Tells me you're hiding something.'' ''Thirteen: Tells you I'm hiding everything.'' ''Dr. House: Tells me you've got something worth hiding. Some Turkish prison, gay porn... you killed a man just because he was asking too many questions.'' ''Dr. Jeffrey 'Big Love' Cole: Amber She went rogue. Broke the rules.'' ''Dr. House: You also sinned. You have no right to cast the first stone.'' ''Dr. Jeffrey 'Big Love' Cole: And atheists have no right to quote Scripture.'' ''Amber Volakis: Do you think House could be wrong?'' ''Dr. Robert Chase: I thought he fired you.'' ''Amber Volakis: No, he fired the men.'' ''Dr. Robert Chase: I don't think he's wrong.'' ''Amber Volakis: If he is, how would I prove it?'' ''Dr. Robert Chase: Just said I don't think he is.'' ''Amber Volakis: Well, thinking isn't good enough.'' ''Dr. Robert Chase: You'd have to run a blood test for anti-centromere antibodies.'' ''Amber Volakis: Would you mind running the labs?'' ''Dr. Robert Chase: You can't.'' ''Amber Volakis: Well, I can, but...'' ''Dr. Robert Chase: No, I was making a statement. You've been fired, so you no longer have lab privileges. You weren't coming here for advice. You're coming here to con a favor to save your job. Sorry. I'm not working for him anymore, but he can still make my life miserable. to walk away'' ''Amber Volakis: You have a chance to make his life miserable.'' ''Dr. Robert Chase: and turns around I'm insulted. You conned Cameron by appealing to her humanity.'' ''Amber Volakis: I told her what she wanted to hear.'' ''Dr. Robert Chase: And you told me what you thought I wanted to hear.'' ''Amber Volakis: If it's any consolation, I think your motives are more interesting.'' ''Dr. Robert Chase: I cannot believe he fired you. Go draw his blood. Meet you in the lab when I'm done here.'' ''Dr. House: I could have you fired!'' ''Dr. Robert Chase: You've already had me fired.'' ''Dr. House: Which proves that I can.'' ''Dr. Robert Chase: Were the men wrong?'' ''Dr. House: No. That doesn't change the fact...'' ''Dr. Robert Chase: Why are you yelling at me?'' ''Dr. House: Because performing tests for someone who is not a doctor in this hospital...'' ''Dr. Robert Chase: You're frustrated. If you want help, I'm here. If you just need to vent, leave a message.'' ''Dr. Allison Cameron: I like him better like this. You?'' ''Stark: I already can't walk. I can't eat. You're telling me that the rest of my life is in this bed, puking and in pain?'' ''Dr. Gregory House: We can manage the pain.'' ''Stark: I'd rather just get this over with. I've been trapped in this useless body long enough. It'd be nice to finally get out.'' ''Dr. Gregory House: Get out and go where? You think you're gonna sprout wings and start flying around with the other angels? Don't be an idiot. There is no "after." There's just "this."'' ''Dr. Wilson: House!'' ''Dr. Wilson: Why can't you just let him have his fairy tale? If it gives him comfort to imagine beaches and loved ones and life outside a wheelchair...'' ''Dr. Gregory House: Are there 72 virgins too?'' ''Dr. Schaffer: Dr. Foreman. How's she doing?'' ''Dr. Eric Foreman: Fever's gone. AST and ALT are back within normal range. She should be out of here in a few days.'' ''Dr. Schaffer: Gutsy call.'' ''Dr. Eric Foreman: Thanks.'' ''Dr. Schaffer: It wasn't a compliment. If you were wrong, she'd be dead.'' ''Dr. Eric Foreman: I was sure...'' ''Dr. Schaffer: No, you weren't. You couldn't be. There's a reason we have rules. If every doctor did whatever his "gut" told him was right, we'd have a lot more dead bodies to deal with.'' ''Dr. Eric Foreman: It won't happen again.'' ''Dr. Schaffer: Yes, it will because you confused saving her life with doing the right thing. I'm sorry, Dr. Foreman, you're fired.'' ''Kutner: Wait, how do you want us to split up?'' ''House: Good question, Overly Excited Former Foster Kid. There's ten of you. I was thinking six against six... no wait...'' ''House: You ladies have the honor to give the patient a feeding tube, discharge him, and show up for work tomorrow. The rest of you, you're a disappointment. You make me want to stop dangling.'' ''Cole: What are we supposed to be doing? It's almost 4.'' ''Kutner: You've got somewhere to be?'' ''Twin: We know he likes to manipulate people. He's probably testing us.'' ''Amber: To find out what? How long we can look stupid for? He said he'd be here by 3. He's obviously not coming. I'm going home.'' ''Cole: Nobody follow her. She pied pipered nine people right out of the job last week.'' ''Cole: Why are you late?'' ''House: To see who'd put up with it.'' ''Cole: So if we left, we would have been fired?'' ''House: I was gonna fire whoever stuck around. But since everyone stuck around...'' ''Dr. Wilson: You're an idiot. You nearly killed yourself.'' ''House: That was the whole idea.'' ''Dr. Wilson: You wanted to kill yourself?'' ''House: I wanted to nearly kill myself.'' ''House: Why does his throat think his lungs are his stomach?'' ''House: Can't let you leave. I think you're still suicidal.'' ''Almore: I wasn't trying to off myself.'' ''House: No, that's right. You were just trying to kill the wall.'' ''Dr. Wilson: Just watching you is painful. I'm upping your pain meds.'' ''House: I love you.'' ''House: Without competition we'd still be single-cell organisms.'' ''House: If you're gonna try to take yourself out, why use electricity? You could eat a bullet, or jump off a building...'' ''Dr. Wilson: I love the team thing, by the way.'' ''House: ...or bury yourself alive in Cuddy's cleavage.'' ''House: I'm going to fire the next person who asks me who I'm gonna fire.'' ''Dr. Cuddy: You can't beat me at a foot race.'' ''House: I thought we were dancing.'' ''Dr. Cuddy: How advanced is the pneumonia?'' ''House: It's taking college courses.'' Cast *Hugh Laurie as Gregory House *Lisa Edelstein as Lisa Cuddy *Omar Epps as Eric Foreman *Robert Sean Leonard as James Wilson *Jennifer Morrison as Allison Cameron *Jesse Spencer as Robert Chase *Anne Dudek as Amber Volakis *Edi Gathegi as Jeffrey Cole *Peter Jacobson as Chris Taub *Kal Penn as Lawrence Kutner *Olivia Wilde as Thirteen *Carmen Argenziano as Henry Dobson *Andy Comeau as Travis Brennan *Meera Simhan as Jodi Desai *Brian Klugman as Thomas Stark *Melinda Dahl as Twin 15A *Caitlin Dahl as Twin 15B *Charlie Hofheimer as Mark Allmore *Kathleen York as Dr. Schaffer *Mary Kate Schellhart as Female Fellow *Reynaldo Rosales as Handsome Fellow *Douglas Spain as Latino Fellow *Bobbin Bergstrom as Nurse *Tommy Gerrits as Boy on Bike *Sara Holden as Driver *James A. Marshall as Delivery Man Music * Let Me In by Hot Hot Heat - The song playing on the driver's radio as she's distracted * Not As We by Alanis Morrissette - While House contemplates the afterlife * Pienso Verde by Paco * Don't Trip by St. John Release Dates * United States - October 9, 2007 on Fox * Canada - October 9, 2007 on Global * Australia - October 17, 2007 * Italy - January 30, 2008 (other sources say March 4 on Canale 5) * Netherlands - February 28, 2008 on SBS6 * Denmark - April 19, 2008 on SBS Net * Israel - April 20, 2008 on HOT 3 and YES Stars 3 * Bulgaria - April 22, 2008 on NTV * Germany - September 9, 2008 on RTL * Hungary - September 10, 2008 on TV2 * Czech Republic - September 15, 2008 on TV Nova * Greece - October 4, 2008 on Star * Sweden - March 3, 2009 on TV4 * Poland - March 26, 2009 on TVP2 In Other Languages At last! An easy to translate title! * France & Quebec - ''97 secondes ''(literal translation) * Spain & Latin America - ''97 Segundos ''(literal translation) Links * Episode page at IMDB * Episode article at Wikipedia * A list of the music tracks at Tunefind * What happened to the pills? (Reddit thread) * Episode transcript at Clinic Duty * Episode summary at House Clinic * Episode guide at House MD Guide * Episode review at IGN * Episode review at Popsugar * Episode technical specifications at Shotonwhat * A list of the music tracks at What Song * Episode guide at AceShowBiz * Episode summary at DeadOn blog * Episode article at TV.com * A review of the medicine at Polite Dissent (via archive.org) ''This article was the featured article for March, 2018 Category:Episodes Category:Season 4 Category:Episodes ending in the patient's death Category:Zebra Factor 2 Category:Featured articles